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Background: Bipolar disorder is a chronic relapsing and mostly severe psychiatric disorder accompanied with a significant psychiatric comorbidity, considerable role impairment, and significant risk of suicide attempts according to recent researches. Mood stabilizers and antipsychotic medications have proved to be effective in managing symptoms for many patients. Nevertheless, medication noncompliance for some patients is a raising concerns. Additional risk for increased symptom severity and relapse when subjected to high levels of psychosocial stress, such as living in a negative family environment has also been reported. Psychosocial treatments, such as cognitive-behavioral therapy (CBT) and family-focused therapy (FFT) were hence introduced in hope of an integrated strategy for the management of bipolar disorder. Objective of the Study: This article is intended to review the optimal approach for the management of bipolar disorder. Advances in biopsychosocial treatments are also briefly reviewed, including new health service models for providing care. Methods: Electronic search in the scientific database from 1960 to 2017- The studies in this comprehensive review were selected for inclusion based on clinical relevance, importance, and robustness of data related to diagnosis and treatment of bipolar disorder. The search terms that were initially used on MEDLINE/PubMed and Google Search terms included "bipolar disorder," "mania," "bipolar depression," "mood stabilizer," "atypical antipsychotics," and "antidepressants." High-quality, recent reviews of major relevant topics were included to supplement the primary studies. Results: Bipolar disorder is a major public health concern. Management includes a lifetime course of medication and attention to psychosocial issues for patients and their families. Standardized treatment guidelines for the management of acute mania have been developed. New potential treatments are being investigated. Conclusion: Bipolar disorder have a very dynamic and chronic nature and thus, careful selection of a treatment should be tailored to the phases of the disorder, together with the safety profile identified in clinical trials. Nevertheless, Psychosocial interventions, such as CBT and FFT should be employed in combination with pharmacological therapy for bipolar patients in order to increase medication compliance, decrease depressive symptoms and recognize early warning signs of an affective episode should ideally help to optimize the course and outcome of this devastating condition. [ABSTRACT FROM AUTHOR]

Background: Toxoplasmosis is a zoonosis with a high prevalence throughout the world. Toxoplasma gondii infection is frequently asymptomatic. Primary school children are particularly vulnerable to toxoplasmosis due to their habits of playing in water, soil, eating various raw foods, or contact with pets, including dogs, cats, and birds and hence they are an ideal target group to investigate T. gondii prevalence. Data collected from this age group can thus be used to assess whether T. gondii threatens the health of school-aged children, and also as a reference for evaluating the need for community interventions. The aim of this study was to determine the prevalence rate of antitoxoplasmosis IgG and IgM in Primary School children and to detect agents that increase prevalence of the disease. Materials and methods: 328 primary children (219 females and 109 males) were screened for T. gondii antibodies with ELISA along with a questionnaire conducted to all children and parents/guardians to obtain data for relevant eating and social habits. Among the risk factors tested, including contact with cats and soil, consumption of raw meat and vegetables, and drinking unboiled milk. Results: the seroprevalence of anti-Toxoplasma IgG & IgM was found to be 12 % (40 out of 328) and 2.4 % (8 out of 328), respectively while combined anti Toxoplasma IgG & IgM antibodies were found in 1.5 % of the children (5 out of 328). Infection acquisition rate was directly proportional to age and it was of interest that the most significant risk factor was not the petting of cats but the ingestion of raw meat. The seroprevalence of T. gondii IgG & IgM by ELISA among primary children in this region of Saudi Arabia is considerable with few identifiable significant risk factors reported. Conclusion: effective measures should be taken to prevent and control T. gondii infection in primary school children, the results of this study showed that in order to increase awareness of the disease in the community especially for girls and their parents on common root causes such as raw meat and vegetable is necessary. Policy makers also need to initiate prevention and control programs to not only primary children but also pregnant women and immunocompromised patients in particular because they are more severely affected by T. gondii infection. [ABSTRACT FROM AUTHOR]